John Edward Anderson, DO

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

34.016830 Issued in OH

Practice address

2222 Cherry St Ste 2000
Toledo, OH 43608-2673

Phone

(419) 251-2061

NPI assigned

May 22, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19827/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/2229/brand/3/csg/621/fhir/r4
• FHIR API: https://hkc.nationwidechildrens.org/FHIR/MYCHART/api/FHIR/R4
• Direct secure messaging: janderson2489286@direct.bsmhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northwest Pediatric Specialists, LLC

  • Pediatrics Physician
  • Toledo, OH
  • NPI 1033709100
  Medicare reassignment NPD
• Detroit Wayne County Health Authority

  • Primary Care Clinic/Center
  • Detroit, MI
  • NPI 1962733089
  NPD (past)
• Partners in Wellness

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1518461524
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1356908552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 CHERRY ST STE 2000",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082673",
            "telephone_number": "419-251-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 CHERRY ST STE 2000",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082673",
            "telephone_number": "419-251-2061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7640 Sylvania Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Sylvania",
            "state": "OH",
            "postal_code": "435609263",
            "country_code": "US",
            "telephone_number": "419-251-2061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2213 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436082603",
            "country_code": "US",
            "telephone_number": "419-251-2061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2142 N Cove Blvd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436063895",
            "country_code": "US",
            "telephone_number": "419-251-2061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "419-251-2061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-22",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "OH",
            "license": "34.016830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0031377",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ja'Nya Unique Elizabeth Anderson
• Jajuan Anderson
• James Douglas Anderson
• Jared Anderson
• Jarmara Anderson
• Jori B Anderson, LSW, BSW
• Kameka Yvonne Anderson, CNP
• Kelly Anderson
• Kevin Edward Anderson, PH.D.
• Kristen Anderson

• Pediatric Sports Medicine Physician in Toledo, OH
• Providers in Toledo, OH by specialty
• Pediatric Sports Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.